HESI RN
HESI Leadership and Management
1. A client with hyperthyroidism is being treated with radioactive iodine. The nurse should teach the client to expect which of the following side effects?
- A. Increased heart rate
- B. Hypothyroidism
- C. Hypercalcemia
- D. Weight loss
Correct answer: B
Rationale: When a client with hyperthyroidism undergoes radioactive iodine treatment, it often leads to hypothyroidism due to the destruction of thyroid tissue. This occurs as a desired outcome of the treatment to reduce the overactive thyroid function. Choices A, C, and D are incorrect. Increased heart rate, hypercalcemia, and weight loss are not expected side effects of radioactive iodine treatment for hyperthyroidism. Instead, the goal is to suppress the overactive thyroid, leading to a hypothyroid state.
2. Which nursing diagnosis takes the highest priority for a female client with hyperthyroidism?
- A. Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess
- B. Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing
- C. Body image disturbance related to weight gain and edema
- D. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
Correct answer: D
Rationale: The correct answer is D: Imbalanced nutrition: Less than body requirements related to thyroid hormone excess. In hyperthyroidism, increased metabolic rate leads to increased nutritional needs, causing weight loss and muscle wasting. Therefore, addressing imbalanced nutrition due to excessive thyroid hormone is a priority. Choice A is incorrect as hyperthyroidism typically leads to weight loss, not weight gain. Choice B is less of a priority as skin issues are secondary to the metabolic disturbances caused by hyperthyroidism. Choice C, body image disturbance, is important but addressing the client's nutritional needs should take precedence to prevent further complications.
3. For a male client with hyperglycemia, which assessment finding best supports a nursing diagnosis of Deficient fluid volume?
- A. Cool, clammy skin
- B. Distended neck veins
- C. Increased urine osmolarity
- D. Decreased serum sodium level
Correct answer: C
Rationale: Increased urine osmolarity is the best assessment finding supporting a nursing diagnosis of Deficient fluid volume in a male client with hyperglycemia. In hyperglycemia, there is increased glucose in the blood, which leads to osmotic diuresis. This results in the excretion of large amounts of urine that is concentrated (high osmolarity), leading to dehydration and fluid volume deficit. Cool, clammy skin (Choice A) is more indicative of poor perfusion, distended neck veins (Choice B) are associated with fluid volume excess, and decreased serum sodium level (Choice D) could be a result of dilutional hyponatremia due to fluid overload rather than deficient fluid volume.
4. An external insulin pump is prescribed for a client with DM. The client asks the nurse about the functioning of the pump. The nurse bases the response on the information that the pump:
- A. Gives small continuous doses of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dosage from the pump before each meal.
- B. Is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals.
- C. Is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin into the bloodstream.
- D. Continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels.
Correct answer: A
Rationale: The correct answer is A. An external insulin pump delivers small continuous doses of regular insulin subcutaneously throughout the day to meet the basal insulin needs. The client can also self-administer a bolus dose with an additional dosage from the pump before each meal to cover the mealtime insulin needs. Option B is incorrect as insulin pumps do not typically release programmed doses of insulin into the bloodstream at specific intervals; instead, they infuse insulin subcutaneously. Option C is incorrect as insulin pumps are not surgically attached to the pancreas; they are worn externally. Option D is incorrect as NPH insulin is not commonly used in insulin pumps, and the pumps do not continuously infuse insulin directly into the bloodstream but rather subcutaneously.
5. The healthcare professional is educating a client with Cushing's syndrome about dietary management. Which of the following instructions should the healthcare professional include?
- A. Increase sodium intake
- B. Limit protein intake
- C. Limit calcium intake
- D. Increase potassium intake
Correct answer: D
Rationale: For clients with Cushing's syndrome, they are at risk of developing hypokalemia due to increased excretion of potassium. Therefore, it is essential to advise them to increase their potassium intake. Choices A, B, and C are incorrect because: A) Increasing sodium intake can worsen fluid retention and hypertension common in Cushing's syndrome. B) Limiting protein intake is not necessary unless there are specific kidney issues that require protein restriction. C) Limiting calcium intake is not typically recommended unless there are underlying conditions such as hypercalcemia.
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